(Removal of the Esophagus)
An esophagectomy is the removal of part or all of the esophagus. The esophagus is the tube that runs from the mouth to the stomach.
Reasons for Procedure
This is done to treat:
- Esophageal cancer
- Benign tumors and cysts
- Severe trauma
- Other problems, such as achalasia or Barrett esophagus
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Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia, such as wheezing or sore throat
- Blood clots
- Leaks from the internal stitches that may cause scarring
- Heart attack
Things that may raise the risk of problems are:
What to Expect
Problems To Look Out For
Call your doctor if you are not getting better or you have:
- Signs of infection, such as fever and chills
- Redness, swelling, excess bleeding, or pus from the incisions
- Pain that you cannot control with medicine
- Nausea or vomiting
- Breathing problems
- Swallowing problems
If you think you have an emergency, call for medical help right away.
Prior to Procedure
The surgical team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Clearing the intestines using an enema the night before
- Whether you need a ride to and from surgery
- Tests that will need to be done before surgery, such as imaging
General anesthesia will be used. You will be asleep.
Description of the Procedure
There are 3 different ways this may be done:
- An open procedure uses 1 longer incision in the neck, chest, or belly. The part of the esophagus that is causing problems will be found and removed.
- A laparoscopic procedure uses many small incisions in the belly or chest. A tiny camera and small tools are inserted in tubes placed in the incisions. The esophagus can be seen on a screen. The part that is causing problems will be found and removed.
- A robot-assisted procedure uses several small incisions in the belly or chest. The doctor will guide small robotic arms through the incisions to find and remove the part that is causing problems.
A replacement esophagus will be formed with part of the stomach or large intestine. The rest of the esophagus will be attached to this replacement. The lymph nodes of people who have cancer may also be removed. One or more chest tubes are placed to drain fluids. The incisions will be closed. Bandages will be placed over them.
How Long Will It Take?
About 6 hours
Will It Hurt?
Anesthesia will block pain during surgery. Pain and swelling are common in the first few weeks. Medicine and home care can help.
Average Hospital Stay
The usual length of stay is 1 to 2 weeks. You may need to stay longer if you have any problems.
At the Hospital
Right after the procedure, the staff may:
- Give you pain medicine
- Give you nutrition through a feeding tube
During your stay, the hospital staff will take steps to lower your risk of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to lower your risk of infection, such as:
- Washing your hands often and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Not letting others touch your incisions
It will take 6 to 8 weeks to recover. Physical activity will be limited at first. Dietary changes will also need to be made. You will need to ask for help with daily activities and delay returning to work.
- Esophagectomy. UCSF website. Available at: https://surgery.ucsf.edu/conditions--procedures/esophagectomy.aspx.
- Management of esophageal and esophagogastric junction cancer. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/management-of-esophageal-and-esophagogastric-junction-cancer.
- Rustgi, A.K. and El-Serag, H.B. Esophageal carcinoma. N Engl J Med, 2014; 371 (26): 2499-2509.
- Surgical removal of the esophagus (esophagectomy). UC Davis Health System website. Available at: http://www.ucdmc.ucdavis.edu/surgery/specialties/cardio/esophagus.html.
- Marcin Chwistek, MD
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